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https://www.readbyqxmd.com/read/29102076/prevention-of-surgical-site-infection-analysis-and-narrative-review-of-clinical-practice-guidelines
#1
Francisco Javier Gómez-Romero, Maria Fernández-Prada, Juan Francisco Navarro-Gracia
Surgical site infection is one of the most prevalent healthcare-associated infections and presents a considerable morbidity. The aim of this comprehensive narrative review is to describe the evidence and grade of recommendation of the preventive measures developed in the three phases of the surgical process (preoperative, perioperative and postoperative phases), as well as coincidences and divergences between selected Clinical Practice Guidelines (CPG). Four preventive measures were recommended with similar high grade evidence in all CPG: Hair removal, antibiotic prophylaxis, surgical site preparation and normothermia...
November 2017: Cirugía Española
https://www.readbyqxmd.com/read/29040358/tissue-expansion-using-hyaluronic-acid-filler-for-single-stage-ear-reconstruction-a-novel-concept-for-difficult-areas
#2
Amir Inbal, Benjamin T Lemelman, Eran Millet, Andrew Greensmith
Background: Auricular reconstruction is one of the most challenging procedures in plastic surgery. An adequate skin envelope is essential for cartilage framework coverage, yet few good options exist without additional surgery. We propose a novel method for minimally invasive tissue expansion, using hyaluronic acid (HA) filler to allow for single-stage ear reconstruction. Objectives: To introduce the novel concept of HA filler for tissue expansion in ear reconstruction, and as an alternative to traditional expansion techniques...
October 16, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28919125/multi-institution-analysis-of-infection-control-practices-identifies-the-subset-associated-with-best-surgical-site-infection-performance-a-texas-alliance-for-surgical-quality-collaborative-project
#3
Catherine H Davis, Lillian S Kao, Jason B Fleming, Thomas A Aloia
BACKGROUND: In an effort to reduce surgical site infection (SSI) rates, a large number of infection control practices (ICPs), including operating room attire policies, have been recommended. However, few have proven benefits and many are costly, time-consuming, and detrimental to provider morale. The goal of this multi-institution study was to determine which ICPs are associated with lower postoperative SSI rates. STUDY DESIGN: Twenty American College of Surgeons NSQIP and Texas Alliance for Surgical Quality-affiliated hospitals completed this Quality Improvement Assessment Board-approved study...
August 16, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28895117/updated-view-on-epidemiology-and-clinical-aspects-of-pilomatricoma-in-adults
#4
Geo Han, Ae-Ree Kim, Hae Jun Song, Chil Hwan Oh, Jiehyun Jeon
BACKGROUND: Clinically, pilomatricoma offers potential for a wide spectrum of differential diagnoses. It typically occurs in pediatric patients with the head being the most common location. A second peak of clinical presentation occurs in adults at age 50-65 years, suggesting a bimodal pattern of occurrence. OBJECTIVE: To investigate the clinical and epidemiological features of pilomatricoma in adults over 20 years old, as it is a common and frequently misdiagnosed tumor...
October 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28690864/surgical-site-infections-after-cesarean-delivery-epidemiology-prevention-and-treatment
#5
REVIEW
Tetsuya Kawakita, Helain J Landy
Cesarean delivery (CD) is one of the most common procedures performed in the United States, accounting for 32% of all deliveries. Postpartum surgical site infection (SSI), wound infection and endometritis is a major cause of prolonged hospital stay and poses a burden to the health care system. SSIs complicate a significant number of patients who undergo CD - 2-7% will experience sound infections and 2-16% will develop endometritis. Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28690206/combination-of-oral-antibiotics-and-mechanical-bowel-preparation-reduces-surgical-site-infection-in-colorectal-surgery
#6
Kerri A Ohman, Leping Wan, Tracey Guthrie, Bonnie Johnston, Jennifer A Leinicke, Sean C Glasgow, Steven R Hunt, Matthew G Mutch, Paul E Wise, Matthew L Silviera
BACKGROUND: Surgical site infections (SSI) are a common complication after colorectal surgery. An infection prevention bundle (IPB) was implemented to improve outcomes. STUDY DESIGN: A standardized IPB that included the administration of oral antibiotics with a mechanical bowel preparation, preoperative shower with chlorhexidine, hair removal and skin preparation in holding, antibiotic wound irrigation, and a "clean-closure" protocol was implemented in January 2013...
October 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28664390/clinical-application-of-intense-pulsed-light-depilation-technology-in-total-auricular-reconstruction
#7
Ying Guo, Jing Shan, Tianyu Zhang
Although ear reconstruction technology has been highly developed in recent years, hair growth on the reconstructed ear has plagued both surgeons and patients. In this paper, the authors introduce a clinical application of intense pulsed light depilation in total auricular reconstruction. From August 2012 to August 2013, 27 patients (28 ears) suffering from congenital microtia were treated by intense pulsed light depilation (650-950-nm filter, initial fluence of 14-16 J/cm(2) and gradually increased, pulse width of 30-50 ms, spot size of 20 × 30 mm(2), intervals of 6-8 weeks, a total of four sessions) either before or after auricular reconstruction...
August 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28660816/the-role-of-antimicrobial-sutures-in-preventing-surgical-site-infection
#8
REVIEW
D Leaper, P Wilson, O Assadian, C Edmiston, M Kiernan, A Miller, G Bond-Smith, J Yap
INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28263778/evaluation-of-the-bundle-zero-surgical-site-infection-to-prevent-surgical-site-infection-in-vascular-surgery
#9
María Fernández-Prada, Carmen Martínez-Ortega, Livia Revuelta-Mariño, Ángeles Menéndez-Herrero, Juan F Navarro-Gracia
OBJECTIVE: To compare the incidence of Surgical Site Infections (SSIs) before and after the implementation of a bundle of care called 'Zero Surgical Site Infection'. Secondary goals included estimating measures of association and their potential impact, determining care management indicators in vascular surgery, and evaluating the level of compliance with the bundle. METHODS: This is a prospective observational study with a historic control group. The bundle included: 1) removal of body hair with clippers; 2) preoperative showering with chlorhexidine soap; 3) preparation of the surgical field with alcoholic chlorhexidine 2%; 4) adequacy of antimicrobial prophylaxis; 5) and 6) intra- and post-operative glycemic and central temperature control...
March 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27875033/comparison-of-preoperative-hair-removal-methods-for-the-reduction-of-surgical-site-infections-a-meta-analysis
#10
REVIEW
Dingmei Shi, Yao Yao, Weifei Yu
AIMS AND OBJECTIVES: To evaluate the efficacy of different methods of preoperative hair removal in reducing surgical site infections. BACKGROUND: Surgical site infections are a major source of morbidity and prolonged hospitalisation following surgery. However, there is a lack of data regarding the impact of different preoperative hair removal techniques on the incidence of surgical site infections. DESIGN: A systematic literature review and meta-analysis...
October 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27687471/impact-of-hair-removal-on-surgical-site-infection-rates-a-prospective-randomized-noninferiority-trial
#11
RANDOMIZED CONTROLLED TRIAL
Todd J Kowalski, Shanu N Kothari, Michelle A Mathiason, Andrew J Borgert
BACKGROUND: Despite substantial prevention efforts, surgical site infections (SSIs) remain the most common health care-associated infection. It is unclear whether the Centers for Disease Control and Prevention recommendation to leave hair intact preoperatively reduces SSIs. STUDY DESIGN: A single-center, prospective, randomized, clinical trial was conducted from October 2009 to February 2015 in a 325-bed multispecialty, tertiary care teaching hospital to test the noninferiority of clipping hair to no hair removal in the prevention of SSIs...
November 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27631825/applying-neurotrophins-to-the-round-window-rescues-auditory-function-and-reduces-inner-hair-cell-synaptopathy-after-noise-induced-hearing-loss
#12
David J Sly, Luke Campbell, Aaron Uschakov, Saieda Tasfia Saief, Matthew Lam, Stephen J O'Leary
HYPOTHESIS: Applying neurotrophins to the round window immediately after a single noise exposure will prevent noise-induced hidden hearing loss. BACKGROUND: Loud noise can eliminate neural connections between inner hair cells and their afferent neurons (thereby diminishing sound perception) without causing a detectable change on audiogram. This phenomenon is termed hidden hearing loss. METHODS: Guinea pigs were exposed for 2 hours to 4 to 8 kHz noise at either 95 or 105 dB SPL...
October 2016: Otology & Neurotology
https://www.readbyqxmd.com/read/27141237/rapunzel-syndrome-rare-tale-of-a-broken-tail
#13
Narvir S Chauhan, Satish Kumar, Rohit Bhoil
BACKGROUND: Rapunzel syndrome is a rare and unique form of trichobezoar, in which a cast of hairs is formed in the stomach with its 'tail' extending up to varying lengths into the small bowel. Almost all cases described in literature are of 'classic' and more common form of Rapunzel. Sometimes however, the tail of bezoar is broken into smaller fragments. There is not much literature available on this rarer subset of Rapunzel syndrome. CASE REPORT: In this report we present the ultrasound (USG) and CT findings of a case of Rapunzel syndrome in which the tail had broken into five separate fragments...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/26690708/improving-outcomes-in-pilonidal-sinus-disease
#14
Sarah Braungart, Mark Powis, Jonathan R Sutcliffe, Ian D Sugarman
BACKGROUND: Optimal surgical treatment for pilonidal sinus disease remains controversial. Studies in children are uncommon with overall high postoperative recurrence and infection rates (20%). Our unit adopted a technique for excision of the pilonidal sinus with primary midline closure using a full-thickness flap. We present our results of this technique in the pediatric age group. METHODS: Single-center retrospective review and telephone follow-up was performed, including all children undergoing pilonidal sinus excision from 2005 to 2014 using the same operative technique and preoperative/postoperative care...
February 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26456021/impact-of-a-surgical-site-infection-reduction-strategy-after-colorectal-resection
#15
T M Connolly, C Foppa, E Kazi, P I Denoya, R Bergamaschi
AIM: This study was performed to determine the impact of a surgical site infection (SSI) reduction strategy on SSI rates following colorectal resection. METHOD: American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data from 2006-14 were utilized and supplemented by institutional review board-approved chart review. The primary end-point was superficial and deep incisional SSI. The inclusion criterion was colorectal resection. The SSI reduction strategy consisted of preoperative (blood glucose, bowel preparation, shower, hair removal), intra-operative (prophylactic antibiotics, antimicrobial incisional drape, wound protector, wound closure technique) and postoperative (wound dressing technique) components...
September 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/26320612/preoperative-hair-removal-and-surgical-site-infections-network-meta-analysis-of-randomized-controlled-trials
#16
REVIEW
A Lefebvre, P Saliou, J C Lucet, O Mimoz, O Keita-Perse, B Grandbastien, F Bruyère, P Boisrenoult, D Lepelletier, L S Aho-Glélé
Preoperative hair removal has been used to prevent surgical site infections (SSIs) or to prevent hair from interfering with the incision site. We aimed to update the meta-analysis of published randomized controlled trials about hair removal for the prevention of SSIs, and conduct network meta-analyses to combine direct and indirect evidence and to compare chemical depilation with clipping. The PubMed, ScienceDirect and Cochrane databases were searched for randomized controlled trials analysing different hair removal techniques and no hair removal in similar groups...
October 2015: Journal of Hospital Infection
https://www.readbyqxmd.com/read/26108306/rapunzel-syndrome-presenting-as-jejuno-jejunal-intussusception
#17
Sanjay Marwah, Siddharth Pandey, Abhishek Raj, Mahavir Singh Jangra, Himanshu Sharma
The term Rapunzel syndrome is used to describe a trichobezoar of the stomach with a long tail of hair extending into the duodenum and small intestine. It is a rare clinical entity, and it is even rarer in these cases that jejuno-jejunal intussusception and resulting intestinal obstruction is a presenting feature. We report one such case, a young female who presented in the emergency department with abdominal pain and bilious vomiting of short duration. Contrast-enhanced CT of the abdomen enabled a diagnosis of a trichobezoar in the stomach extending into the small gut, along with jejuno-jejunal intussusception...
August 2015: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/25984901/role-of-antiseptics-in-the-prevention-of-surgical-site-infections
#18
REVIEW
Kathryn Echols, Michael Graves, Keith G LeBlanc, Sean Marzolf, Avis Yount
BACKGROUND: Antiseptics are chemical agents used to reduce the microbial population on the surface of the skin and are used in nearly every surgical procedure today. Despite this, there are currently no definitive guidelines on surgical preoperative antisepsis that indicate a specific regimen based on demonstration of superior efficacy. OBJECTIVE: This review serves to examine preoperative antisepsis, including cutaneous bacteriology, preoperative hair removal, preoperative decolonization, surgical attire, and the antiseptic agents themselves...
June 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/25701387/-prevention-of-periprosthetic-joint-infections-not-evidence-based-strategies
#19
A Keshmiri, G Maderbacher, C Baier, H-R Springorum, J Grifka, J Schaumburger
BACKGROUND: Surgical site infections are the most common nosocomial infections in orthopedic surgery. Strategies to prevent these infections are of enormous relevance. OBJECTIVES: Evidence-based procedures such as hand disinfection, prophylactic antibiotic application, hair removal with electric clippers, or preoperative treatment of Staphyloccus aureus are listed in national and international guidelines. Beside these measures, several scientifically not confirmed methods, e...
May 2015: Der Orthopäde
https://www.readbyqxmd.com/read/25692267/evidence-update-on-prevention-of-surgical-site-infection
#20
REVIEW
David Leaper, Karen Ousey
PURPOSE OF REVIEW: Surgical site infection (SSI) is a common healthcare-associated infection and complicates up to 10-20% of operations with considerable strain on healthcare resources. Apart from the widely adopted use of appropriate hair removal, antibiotic prophylaxis, avoidance of hypothermia and perioperative glycaemic control to reduce SSIs, this review has considered new research and systematic reviews, and whether their findings should be included in guidelines. RECENT FINDINGS: The efficacy of preoperative bathing/showering, antibiotic prophylaxis for clean surgery and perioperative oxygen supplementation to reduce the risk of SSI is still in doubt...
April 2015: Current Opinion in Infectious Diseases
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